Toward a functional neuroanatomy of premenstrual dysphoric disorder
Toward a functional neuroanatomy of premenstrual dysphoric disorder
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DOI：
10.1016/j.jad.2007.09.015
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发表时间：
2008-05-01
影响因子：
6.6
通讯作者：
Silbersweig, David
中科院分区：
文献类型：
--
作者：
Protopopescu, Xenia;Tuescher, Oliver;Silbersweig, David
背景资料：经前焦虑障碍（PMDD）是一种常见的情感性疾病，与显著的发病率相关。这种诊断不足和治疗不足的疾病的神经生物学知之甚少。额边缘功能的功能磁共振成像（fMRI）探头被用来推进理解PMDD pathophysiology.Methods：我们采用BOLD功能磁共振成像和统计参数映射研究神经反应的情绪词的背景下，情绪去/NoGo抑制控制任务。我们研究了在整个月经周期，在月经前（黄体晚期）阶段和月经后（卵泡晚期）phase.Results：在月经前（与月经后）阶段，PMDD受试者，与无症状的受试者相比，表现出增加杏仁核反应的负面与中性刺激，和减少腹侧纹状体反应的正面与中性刺激。PMDD受试者在经前期与经后期对负性与中性刺激的内侧眶额皮质（OFC）反应增加和外侧眶额皮质（OFC）反应减少的模式均未表现出无症状受试者的模式。这减少经前内侧OFC反应的负面刺激在PMDD科目的背景下，进一步增强了behavioral inhibit 1 n.Limitations：进一步的研究与更多的科目是needed.Conclusions：结果支持神经生物学模型的增强负性情绪处理，减少积极的情绪处理，并减少自上而下的控制边缘系统的活动在PMDD在经前期。这些发现为PMDD的神经回路模型提供了基础，并对健康和疾病中人类月经周期的情绪/情绪调节研究产生了影响。(C)2007 Elsevier B. V.保留所有权利。
Background: Premenstrual dysphoric disorder (PMDD) is a prevalent disorder in the spectrum of affective illness, and is associated with significant morbidity. The neurobiology of this underdiagnosed and undertreated illness is poorly understood. A functional magnetic resonance imaging (fMRI) probe of fronto-limbic function was used to advance understanding of PMDD pathophysiology.Methods: We applied BOLD fMRI and Statistical Parametric Mapping to study neural response to emotional words in the context of an emotional Go/NoGo inhibitory control task. We examined alterations in this response across the menstrual cycle, in the premenstrual (late luteal) phase and the postmenstrual (late follicular) phase.Results: In the premenstrual (vs. postmenstrual) phase, PMDD subjects, compared with asymptomatic subjects, showed an increased amygdala response to negative vs. neutral stimuli, and a decreased ventral striatum response to positive vs. neutral stimuli. PMDD subjects failed to show the asymptomatic subjects' patterns of increased medial and decreased lateral orbitofrontal cortex (OFC) response to negative vs. neutral stimuli in the premenstrual vs. postmenstrual phase. This decreased premenstrual medial OFC response to negative stimuli in PMDD subjects was further enhanced in the context of behavioral inhibition.Limitations: Further studies with larger numbers of subjects are needed.Conclusions: The results support a neurobiological model of enhanced negative emotional processing, diminished positive emotional processing, and diminished top-down control of limbic activity in PMDD during the premenstrual phase. These findings provide a basis for a neurocircuitry model of PMDD, and have implications for studies of mood/emotional regulation across the human menstrual cycle in health and disease. (C) 2007 Elsevier B.V. All rights reserved.